An Observational Study On The Expression Of Risk Factors For Coronary Artery Damage In Kawasaki Disease

Objective: Retrospective analysis of the expression of various risk factors in children with Kawasaki disease(KD)and correlation with coronary artery lesions(CAL),providing a reference for early clinical diagnosis and treatment of Kawasaki disease,thereby reducing serious complications such as coronary artery disease happened.Methods: A retrospective analysis was performed to collect all the first-time children who were hospitalized in the General Hospital of Ningxia Medical University from January 2014 to December 2017,and were treated with intravenous gamma globulin(IVIG)in combination with aspirin.Collect hospitalization data,including age,gender,clinical symptoms,WBC,N%,N,L,Hct,PLT,Na,ALB,AST,ALT,hypersensitive CRP,cardiac ultrasound,IVIG application time,etc.,according to coronary artery damage The presence or absence of the patients was divided into coronary artery lesion group(CAL group)and coronary artery lesion group(NCAL group),and statistical analysis was performed using SPSS22.0 software.Result:(1)Sex comparison between the two groups.Among the 140 children,97 were male and 43 were female,and the ratio of male to female was 2.26:1.There were 69 patients in the CAL group,including 57 males(40.72%)and 12 females(8.57%).The male to female ratio was 4.75:1;71 patients in the NCAL group,40 males(28.57%)and 31 females(22.14%).The ratio of male to female is 1.29:1.The incidence of CAL was 49.29%.There was a significant difference between the two groups of data(P < 0.05).(2)Age comparison between the two groups,the minimum age is 54 days,and the maximum is 9 years old and May.Among them,CAL group,17 cases were 0~1 years old,42 cases were 1~3 years old,6 cases were 3~5 years old,4 cases were over 5 years old,the average age was 1.9±1.4(years old);16 cases of NCAL group 0~1 years old,There were 29 cases in 1~3 years old,17 cases in 3~5 years old,and 9 cases in 5 years old and above.The average age was 2.6±1.7(years old).The difference between the two groups was significant(P<0.05).(3)Comparison of clinical symptoms between the two groups,the incidence from high to low was fever for more than 5 days(100%),conjunctival hyperemia(89.3%),oral mucosal changes(88.6%),skin changes(78.6%),Symptoms of hand and foot(70.0%),cervical lymphadenopathy(63.6%).In other accompanying clinical manifestations,the incidence of respiratory symptoms was 45.7%,the incidence of digestive symptoms was 29.3%,the incidence of perianal peeling was 14.1%,and the incidence of joint pain was 7.1%.In the main clinical symptoms,conjunctival hyperemia,oral mucosal changes,and skin changes were not significantly different between the two groups(P>0.05).There were statistical differences between the two groups in the symptoms of hand and foot and cervical lymphadenopathy(P<0.05).(4)Comparison of laboratory indicators between the two groups: Univariate regression analysis showed that the expression levels of WBC,N,NLR,PLR and hypersensitive CRP in CAL group were higher than those in NCAL group,and there was significant difference between the two groups(P<0.05).There was no significant difference in the expression of N%,L,Hct,PLT,Na,ALB,AST and ALT(P>0.05).(5)Logistic multivariate regression analysis showed that WBC,N,PLR and hypersensitive CRP were independent risk factors for concurrent CAL(P<0.05).(6)The ROC curve shows that all factors are meaningful when the predictive value of risk factors is tested separately,but the predictive value is not significant.When combining all risk factors(age,gender,WBC,N,NLR,PLR and hypersensitivity)At CRP),the predicted value was the highest(sensitivity and specificity were 0.73,and the area under the ROC curve was 0.783).Conclusion: 1.WBC,N,PLR and hypersensitive CRP are independent risk factors for CAL in children with KD.2.Limb changes and cervical lymph node enlargement may be related risk factors for KD complicated with CAL.3.WBC,N,PLR,and hypersensitive CRP are not high in predicting the occurrence of CAL,but have certain auxiliary functions.When combined with all relevant risk factors,the predicted value is the highest,so effective measures can be taken to predict and prevent CAL.The occurrence and development.